General Dermatology

The skin is the body's largest organ and plays a vital role in protecting our overall health and wellbeing. It acts as a barrier against bacteria, viruses, allergens, chemicals, and physical injury, while helping to prevent excessive water loss and maintain hydration. The skin also regulates body temperature, supports the immune system, enables our sense of touch, and is essential for the production of vitamin D. Healthy skin contributes not only to physical health but also to confidence, comfort, and quality of life. When the skin becomes affected by conditions such as eczema, psoriasis, acne, rosacea, or skin cancer, these important functions can be disrupted, causing physical discomfort as well as emotional and social challenges. Caring for the skin and seeking expert advice when concerns arise can help maintain its health, restore its protective function, and improve overall wellbeing.

Eczema is a common, long-term inflammatory skin condition that affects people of all ages, although it most often begins in infancy or early childhood. It is characterised by dry, itchy, inflamed skin, with symptoms that tend to fluctuate over time. While eczema is a very common condition, it can sometimes be difficult to diagnose when it presents in an atypical way and may be mistaken for other skin disorders. An accurate diagnosis is important to ensure that the most appropriate treatment is started.

Eczema is a complex condition influenced by a combination of genetic, immune, skin barrier, and environmental factors. Flare-ups may be triggered by factors such as changes in weather, skin irritants, allergens, stress, illness, or infections, although triggers vary considerably from person to person. The persistent itch can be particularly distressing, often leading to scratching that further damages the skin, disrupts sleep, and increases the risk of infection. Beyond the physical symptoms, eczema can have a significant impact on quality of life, affecting sleep, concentration, school or work performance, self-confidence, and emotional wellbeing.

Although there is currently no cure, there are many effective treatments available to help control symptoms, reduce flare-ups, restore the skin barrier, and improve quality of life. Treatment may include specialised skincare, topical medications, phototherapy, and systemic therapies for more severe disease. Because eczema varies greatly between individuals, successful management requires a personalised approach that considers the person's age, severity of disease, pattern of symptoms, lifestyle, and treatment goals. Working closely with a dermatologist to develop an individualised treatment plan can help achieve long-term control and maintain healthy skin.

There is also a great deal of misinformation about eczema, particularly online and on social media, and it is common to encounter false claims. While some people have individual triggers that can worsen their symptoms, there is no single treatment or lifestyle change that works for everyone, and approaches that are not supported by scientific evidence may delay effective treatment or make the condition worse. Seeking advice from a qualified dermatologist is important to ensure an accurate diagnosis, identify contributing factors, and develop a treatment plan based on the best available medical evidence. With appropriate care and ongoing support, most people can achieve good control of their symptoms and enjoy a significant improvement in their quality of life.

In some people, eczema may be caused or worsened by contact dermatitis, a type of eczema that occurs when the skin reacts to substances in the environment. This may result from exposure to irritants, or from an allergic reaction to specific substances in skincare and cosmetic products. Because contact dermatitis can closely resemble other forms of eczema, it is often difficult to identify the underlying cause based on appearance alone.

Patch testing is the gold standard investigation for diagnosing allergic contact dermatitis. This specialised test involves applying small amounts of common allergens to the skin under adhesive patches, followed by assessment over several days to determine whether an allergic reaction has occurred. Identifying and avoiding relevant allergens can lead to significant and lasting improvement in symptoms, particularly in people with persistent, recurrent, or treatment-resistant eczema. A dermatologist can determine whether patch testing is appropriate and interpret the results in the context of an individual's skin condition, occupation, hobbies, and everyday exposures.

Acne is one of the most common skin conditions worldwide, affecting up to 85% of adolescents, although it can occur at any age and is increasingly common in adults. It develops when hair follicles become blocked with excess oil (sebum), dead skin cells, and bacteria, leading to blackheads, whiteheads, pimples, and, in some cases, deeper cysts and nodules. Acne is influenced by a combination of factors including genetics, hormones, inflammation, and changes in the skin microbiome. While certain factors such as hormonal fluctuations, stress, some medications, occlusive skincare products, and friction from helmets or face coverings can contribute to flare-ups, acne is not caused by poor hygiene, and many commonly held beliefs about its causes are not supported by scientific evidence. Although acne is a medical condition that can usually be treated effectively, it can have a profound impact on self-esteem, confidence, social interactions, and emotional wellbeing. For some people, it may also result in permanent scarring if left untreated. Seeking early assessment and evidence-based treatment from a dermatologist can help control active acne, reduce the risk of scarring, and improve both skin health and quality of life.

Rosacea is a common, chronic inflammatory skin condition that most often affects the central face, including the cheeks, nose, chin, and forehead. It typically develops in adulthood and is characterised by periods of flare-ups and remission. Rosacea presents in several different phenotypes, and people may experience different combinations of symptoms. These include persistent facial redness, episodes of flushing, visible blood vessels (telangiectasia), acne-like bumps and pustules, thickening of the skin, and eye involvement (ocular rosacea), which can cause irritation, dryness, and redness of the eyes. The exact cause of rosacea is not fully understood and is likely to involve a complex interaction between genetic predisposition, immune system dysregulation, changes in the skin microbiome, environmental factors, and abnormalities in the skin's blood vessels. Many people also identify individual triggers that worsen their symptoms, such as sun exposure, heat, alcohol, spicy foods, emotional stress, or certain skincare products, although these vary considerably from person to person. Rosacea can have a significant impact on confidence and quality of life, particularly because of its visible nature and tendency to fluctuate over time. While there is currently no cure, a range of effective treatments is available to manage the different features of rosacea. These may include tailored skincare, topical and oral medications to reduce inflammation, treatments to address flushing and visible blood vessels, and laser or light-based therapies. Because rosacea varies greatly between individuals, an accurate diagnosis and personalised treatment plan from a dermatologist are key to achieving long-term control and maintaining healthy skin.

Psoriasis is a common, chronic inflammatory skin condition affecting around 2–3% of the population. It occurs when the immune system causes skin cells to grow and shed much more rapidly than normal, resulting in well-defined, red, scaly plaques that most commonly affect the scalp, elbows, knees, lower back, and nails, although any part of the body can be involved. Psoriasis is a complex condition influenced by a combination of genetic, immune, and environmental factors, and symptoms may be triggered or worsened by infections, stress, certain medications, smoking, alcohol, skin injury, or other individual factors. While psoriasis primarily affects the skin, it is now recognised as a systemic inflammatory disease and may be associated with other health conditions, including psoriatic arthritis, cardiovascular disease, obesity, diabetes, and depression. The visible nature of psoriasis, along with symptoms such as itching, discomfort, and scaling, can have a profound impact on self-esteem, relationships, work, and overall quality of life.

Treatment is highly individualised and depends on factors such as the type and severity of psoriasis, the areas of skin involved, the presence of joint disease or other medical conditions, previous treatment responses, and the person's lifestyle and preferences. Management may include topical therapies, phototherapy, oral medications, or targeted biologic therapies, with many people benefiting from a combination of approaches. Advances in treatment over recent years have transformed outcomes for many patients, and working closely with a dermatologist can help identify the most appropriate long-term treatment strategy to achieve effective disease control and improve quality of life.